Delivering a Hub-and-Spoke, Peer-led Community Aphasia Group: workforce learning, acceptability, and implementation challenges

Background Community Aphasia Groups (CAGs) offer a communicatively inclusive, community-oriented approach to aphasia recovery. Hub-and-Spoke, Peer-led CAGs which combine facilitators with and without aphasia, and allied and mental health clinicians may improve CAG access and extend workforce capacity; however, limited evidence exists regarding workforce experiences of delivering such models in practice.Aims This qualitative study explored: (1) Hub clinician and Spoke facilitator experiences of preparing to deliver a proof-of-concept H–S, peer-led CAG service; (2) Hub clinician and Spoke facilitator perceptions of the acceptability of program delivery; and (3) service provider determinants to delivery for the purposes of future planning and implementation.Materials and Methods Three Hub clinicians (clinical personnel) and four Spoke facilitators (non-clinical personnel with and without aphasia), participated in semi-structured interviews. Written debrief session records and clinical progress notes were collected. Data were analysed using thematic analysis for aims 1 and 2, and using content analysis for aim 3.Results The H-S workforce viewed the service as promising. Formal training was valued, but role confidence developed over time. Key challenges included training accessibility, role ambiguity, particularly for facilitators with aphasia, high coordination demands on the Hub speech pathologist, and differing understandings of participation and success. Benefits included shared learning, professional growth, and leadership development.Conclusions Effective implementation of H–S, peer-led CAG services depend not only on training, but on supporting learning through practice, clear role articulation, and sustained reflective support. Addressing these barriers may strengthen acceptability, sustainability, and workforce capacity.